neonatal complications (PTB, RDS, TTN, MAS) Flashcards
classifications for high risk infants
-birth weight (LBW <2500 g)
-gestational age
-predominant pathophysiologic problems
4 neonatal problems associated with prematurity
-developmental delays
-vision and hearing impairment
-persistent RDS
-cerebral palsy
how long does resp distress usually last
72 hours after birth
what age are corrected milestone ages continued until
2.5 yo
cause of RDS
inadequate pulmonary surfactant
risk factors RDS
-**prematurity
-maternal diabetes (IDM don’t produce surfactant until 36 wks)
-perinatal asphyxia
-male
-caucasian
-C/S
S+S RDS
-immediate or within 6 hrs
-crackles (louder, persistent)
-poor air exchange
-pallor
-retractions
-apnea (>20 secs)
how is Dx of RDS made
chest x-ray
prevention RDS
-prevent/treat preterm birth
-accelerate surfactant production: antenatal steroids
-administer surfactant via ET tube at birth
supportive care measures for baby with RDS
-thermoregulation
-resp support (vent)
-prevention of hypoTN and hypovolemia
-correct acidosis
-parenteral feedings (nursing takes too much energy)
-cluster care
options for oxygen admin for RDS
-nasal cannnula
-CPAP
-mechanical vent (intubation - high frequency)
-ECMO
cause of transient tachypnea of the neonate
delayed absorption of fetal lung fluid
TTN
transient tachypnea of neonate
risk factors TTN
-**C/S (esp not preceded by labor)
-smoking during pregnancy
-diabetic mom
-SGA, premature
-rapid vaginal birth
S+S TTN
same RDS
Dx TTN
chest xray: streaking
Tx TTN
-O2
-nutrition: gavage, parenteral or IV fluids
-thermoregulation
-protect from infection
-maintenance of acid base balance
does TTN self resolve?
does RDS?
TTN: yes
RDS: no, turns into BPD
appearance of postterm baby
-decreased subq fat and muscle mass (“old person”)
-absent lanugo and vernix
-dry cracked peeling skin
-long nails
-meconium staining (skin, nails, cord)
cause of meconium aspiration syndrome
-aspiration meconium
-negative pressure created
-hyperinflation of lungs, hypoxemia
-increased peripheral vascular resistance
-right to left shunting and return of fetal circulation
-chemical pneumonias, further decreases gas exchange
risk factors meconium aspiration syndrome
-maternal diabetes/HTN
-difficult birth
-fetal distress
-intrauterine hypoxia (baby takes big gasps)
-advanced gestational age (>40 wk)
-IUGR
S+S meconium aspiration syndrome
-meconium stained amniotic fluid
-meconium staining on baby
-S+S resp distress at birth
-hypothermia
-hypoglycemia, hypocalcemia
-coarse crackles on ausculatation
-visualization of meconium with ET tube
Dx meconium aspiration syndrome
chest x-ray: trapped air, hyperinflated lungs, meconium
Tx meconium aspiration syndrome
-prevention: check amniotic fluid, prevent distress
-chest physiotherapy
-tracheal suctioning at birth prn
-Abx and surfactant
-supplemental O2
-mechanical vent (ECMO)
ECMO
extracorporeal membrane oxygenation
